Obtaining parotid saliva specimens after major surgery

Efficacy of Lemon Mouthwash in Improving Dry Mouth Symptoms and Salivary Flow in Hemodialysis Patients

OBJECTIVES

Gargling mouthwash is a safe and convenient oral care intervention; it rinses the mouth and increases salivary flow rate. The effectiveness of lemon mouthwash in relieving xerostomia and increasing the salivary flow rate among hemodialysis patients has not been studied. Our study sought to analyze the effectiveness of varying concentrations of lemon in mouthwash solutions on xerostomia and salivary flow rate.

METHODS

A multi-concentration test was used to assess lemon mouthwash at 20%, 15%, 10%, 5%, and 2.5% concentrations to determine the optimal concentration for relieving dry mouth and increasing salivary flow rate. Generalized estimating equations were used to analyze the differences between various concentrations of lemon mouthwash and baseline values.

RESULTS

In total, 44 patients were recruited. The 10% lemon concentration mouthwash was the most effective for increasing salivary flow rate, but the 5% and 2.5% were better accepted by the participants. Our findings can help establish intervention guidelines to relieve xerostomia among hemodialysis patients.

CONCLUSION

Our findings can help establish intervention guidelines to relieve xerostomia among hemodialysis patients.

Coaching to vision versus coaching to improvement needs: a preliminary investigation on the differential impacts of fostering positive and negative emotion during real time executive coaching sessions

Drawing on intentional change theory (ICT; Boyatzis, 2006), this study examined the differential impact of inducing coaching recipients’ vision/positive emotion versus improvement needs/negative emotion during real time executive coaching sessions. A core aim of the study was to empirically test two central ICT propositions on the effects of using the coached person’s Positive Emotional Attractor (vision/PEA) versus Negative Emotional Attractor (improvement needs/NEA) as the anchoring framework of a onetime, one-on-one coaching session on appraisal of 360° feedback and discussion of possible change goals. Eighteen coaching recipients were randomly assigned to two coaching conditions, the coaching to vision/PEA condition and the coaching to improvement needs/NEA condition. Two main hypotheses were tested. Hypothesis₁ predicted that participants in the vision/PEA condition would show higher levels of expressed positive emotion during appraisal of 360° feedback results and discussion of change goals than recipients in the improvement needs/NEA condition. Hypothesis₂ predicted that vision/PEA participants would show lower levels of stress immediately after the coaching session than improvement needs/NEA participants. Findings showed that coaching to vision/the PEA fostered significantly lower levels of expressed negative emotion and anger during appraisal of 360° feedback results as compared to coaching to improvements needs/the NEA. Vision-focused coaching also fostered significantly greater exploration of personal passions and future desires, and more positive engagement during 360° feedback appraisal. No significant differences between the two conditions were found in emotional processing during discussion of change goals or levels of stress immediately after the coaching session. Current findings suggest that vision/PEA arousal versus improvement needs/NEA arousal impact the coaching process in quite different ways; that the coach’s initial framing of the session predominantly in the PEA (or, alternatively, predominantly in the NEA) fosters emotional processing that is driven by this initial framing; and that both the PEA (and associated positive emotions) and NEA (and associated negative emotions) play an important and recurrent role in shaping the change process. Further study on these outcomes will enable researchers to shed more light on the differential impact of the PEA versus NEA on intentional change, and how to leverage the benefits of both emotional attractors. Findings also suggest that coaches can benefit from better understanding the importance of tapping intrinsic motivation and personal passions through coaching to vision/the PEA. Coaches additionally may benefit from better understanding how to leverage the long-term advantages, and restorative benefits, of positive emotions during coaching engagements. The findings also highlight coaches’ need to appreciate the impact of timing effects on coaching intentional change, and how coaches can play a critical role in calibrating the pace and focus of work on intentional change. Early arousal of the coachee’s PEA, accompanied by recurrent PEA–NEA induction, may help coachees be/become more creative, optimistic, and resilient during a given change process. Overall, primary focus on vision/PEA and secondary focus on improvement needs/NEA may better equip coaches and coaching recipients to work together on building robust learning, development, and change. Keywords-133pt executive coaching, vision, improvement needs, positive emotion, negative emotion, emotional appraisal, intentional change, positive psychology

Effects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management

The physiological and psychological stress of surgery and postoperative pain can leave patients more susceptible to infection and complications. The present study was designed to determine whether two interventions, patient teaching (PT) for pain management and relaxation/music (RM), reduced cortisol levels, an indicator of stress, following abdominal surgery. Patients (18-75 years) were randomly assigned to receive PT, RM, a combination of the two, or usual care; the 205 patients with both pre- and posttest cortisol values were analyzed. A 2 × 2 factorial design was used to compare groups for PT effects and RM effects. Stress was measured by salivary cortisol before and after 20-min tests of the interventions in the morning and afternoon of postoperative Day 2. Saliva was stimulated with lemon juice and analyzed with high-sensitivity salivary cortisol enzyme immunoassay. Comparisons using analysis of covariance (ANCOVA), controlling for baseline levels, showed no PT effect or RM effect on cortisol in the morning or afternoon. Post hoc ANCOVA showed no significant effects when intervention groups were compared to the control group. Although in previous studies, RM reduced pain and music reduced cortisol on Day 1, in the present study the cortisol response to surgery was not attenuated by PT or RM on Day 2. The RM intervention can be used for pain but needs to be further tested for effects on plasma cortisol in abdominal surgery patients on their first postoperative day.